Rozanova Julia, Noulas Paraskevi, Smart Kathleen, Roy Alicia, Southwick Steven M, Davidson Larry, Harpaz-Rotem Ilan
Department of Internal Medicine, Yale School of Medicine, 135 College Street Suite 351, New Haven, CT, 06510, USA.
VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA.
Psychiatr Q. 2016 Sep;87(3):427-43. doi: 10.1007/s11126-015-9398-7.
This study explored the journey of American armed forces personnel from their decision to join the service, through their service in an active military conflict and how these factors may be associated with potential resistance for mental healthcare. The data came from qualitative interviews with 46 OIF/OEF/OND active-duty military, reservists, and discharged veterans of the average age of 25 years, who presented for a new episode of mental health treatment to a large Veterans Affairs Hospital (VAH) in Northeastern United States in 2011-2012. Qualitative analysis of veterans' perceptions revealed several major themes describing how a mental health diagnosis would negatively impact both their sense of identity and pragmatic career-building goals: enlisting as a career-building avenue, 'noble superhero' identity, escaping from hardship, and mental illness as a career-killer. Findings suggest that factors making young veterans resist mental healthcare may be reduced by partnering VAH psychiatrists with career counselors, and by enhancing military leadership's awareness and understanding about how to support soldiers with emotional and mental health needs, with a goal to eliminating stigma.
本研究探讨了美国武装部队人员从决定参军开始，到在实际军事冲突中服役的历程，以及这些因素如何可能与对心理保健的潜在抵触相关联。数据来自对46名在伊拉克自由行动/持久自由行动/新黎明行动中的现役军人、预备役军人和退伍军人的定性访谈，他们的平均年龄为25岁，于2011年至2012年在美国东北部一家大型退伍军人事务医院（VAH）接受新一轮心理健康治疗。对退伍军人认知的定性分析揭示了几个主要主题，描述了心理健康诊断如何对他们的身份认同感和务实的职业发展目标产生负面影响：将参军作为职业发展途径、“高尚超级英雄”身份、逃避困难以及将精神疾病视为职业杀手。研究结果表明，通过让VAH精神科医生与职业顾问合作，以及提高军事领导层对如何支持有情感和心理健康需求士兵的认识和理解，以消除耻辱感，可能会减少年轻退伍军人抵制心理保健的因素。
